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Case study

A healthcare payer sets its own long-term health strategy

An integrated healthcare payer with low market share and a portfolio weighted toward declining market segments asked Bain for help developing a long-term growth strategy. Bain developed a full-potential plan based on its analysis of the company's core business and adjacent opportunities. The growth plan is now underway and account share improved in less than one year.

  • min read

At a Glance

  • 56 point rise in membership index

The Full Story

The Situation

  • Healthcare Payer Co* was an integrated health system operating in the Eastern part of the US (before US healthcare reform)
  • Client had low market share and its portfolio was heavily weighted towards fully-funded HMO and employer-based business, both of which were declining market segments
  • Healthcare Payer Co faced declining membership and market share in a local, scale-based business
  • Company was losing relevance in the region

Our Approach

The client asked Bain to develop full potential plan grounded in analysis of the core business versus adjacencies:

Our Recommendations

Bain evaluated initial focus areas based on market attractiveness and client likelihood of success:

The Results

Bain developed a growth strategy that would refocus the company on its core business:

 

* We take our clients' confidentiality seriously. While we've changed their names, the results are real. 

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